‘Preserving’ And ‘Restoring’ Fertility For Women: Should We Be Worried?

Advances in assisted reproductive technology

Assisted reproductive technology is advancing rapidly across the world with the invention of various new technologies that can help promote fertility.

Now, not only that these technologies help to achieve pregnancy, they also offer hope and ways to ‘preserve fertility’ for pre-menopausal women and ‘restore’ fertility for post-menopausal women.

Methods of postponing pregnancy

Several methods are available to help women wishing to postpone pregnancy for various grounds, particularly on health reason, through ovarian and egg cryopreservation.

While freezing eggs from adult women is common, its use on pre-pubertal girls is still in its infancy.

Extracting eggs from pre-pubertal girls

In 2016, it was reported that a group of doctors in London and Copenhagen had fertilised embryos in vitro using frozen eggs extracted from a cancer patient when she was eight years old.

More recently, in July 2016, in a study conducted by doctors in the United Kingdom, eggs were extracted from a two-year old girl suffering from cancer and cryopreserved for use later in her life.

Several issues arise from this method:

• Should this procedure be recommended for all young cancer patients?
• What would be the implications or the risks of this procedure for these young girls?
• Who should make this important decision?
• Should parents be put in a position to decide on their child’s fertility prospect when at the same time, they are burdened with more crucial decisions to make concerning their child’s life?

These concerns, however, need to be balanced with the prospect of preventing childlessness for young girls which could be devastating on them in future.

Assisting post-menopausal women

In addition to preserving fertility for young women, new researches are being attempted to assist post-menopausal women to reproduce using their own eggs.

In another recent development, scientists in Greece claimed that they can ‘rejuvenate’ the ovaries of post-menopausal women to stimulate them into producing fertile eggs through the injection of platelet-rich plasma (PRP) collected from the women’s blood.

PRP, which is known to generate the healing of damaged bones and increase blood vessel formation, was injected to the ovaries of 30 menopausal women in Greece.

Researchers claimed that they have succeeded in extracting eggs from these women and fertilised them with sperm but the resulting embryos have yet to be implanted into the woman’s uterus.

Dr Konstantinos Sfakianoudis, a researcher and gynaecologist from the Greek Fertility Centre Genesis Athens commented that this new breakthrough “...offers a window of hope that menopausal women will be able to get pregnant using their own genetic material.”

The need to scrutinise concerns

While these developments may be applauded for offering hope for women to preserve and restore their fertility, their arrival is not free from concerns that need to be scrutinised before the technique can be offered at large.

Although the technique has yet to make its way into Malaysia, discussion on the issues involved is useful as assisted reproductive technology is fast expanding in this country.

Hence, awareness and knowledge on issues on Bioethics particularly concerning assisted reproductive technology in Malaysia needs to be enhanced and promoted.

Dr. Haniwarda Yaakob

Faculty of Law

Universiti Kebangsaan Malaysia

Email: hani_yaakob@yahoo.com

Picture credits: bp.blogspot.com